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Axial T1 C+ fat sat

There is an extra-axial mass along the planum sphenoidale/olfactory groove within the midline with an intermediate signal intensity on T1-weighted sequences and slightly high signal intensity on T2-weighted sequences and measures approximately 2.3 x 2.0 x 1.4 cm. There are areas of susceptibility artifact within the mass consistent with areas of calcification. There is no restricted diffusion. There is homogeneous enhancement with an enhancing dural tail. There is mild mass effect on adjacent brain parenchyma. There is no associated vasogenic edema. The mass does no appear to involve the optic chiasm or invade the paranasal sinuses.

Case Discussion

Olfactory groove/planum sphenoidale meningiomas arise in the midline of the anterior cranial fossa overlying the cribriform plate, frontosphenoid suture and planum sphenoidale. They are typically benign. They can cause hyperostosis in the scull base or invade the sinuses, and rarely, the orbits. The primary blood supply is from the anterior and posterior ethmoid arteries. They can be also supplied by the meningeal branches from the ophthalmic artery, anterior cerebral arteries, anterior communicating artery, pial collaterals and external carotid circulation.

Most patients are women in their 5th and 6th decades of life. Most common symptoms are subtle mental changes in cognition and personality, headaches, visual decline and seizures. Anosmia may be present.